| NPI | 1447319629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: DC OP1000098) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD 502MM869) |
| 152W00000X Optometrist (Licence: MD TA9147) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |